<!DOCTYPE html>
<html>
<head>
    <meta charset="utf-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>样本信息录入</title>
    <link rel="shortcut icon" href="favicon.ico">
    <link href="css/bootstrap.min.css?v=3.3.6" rel="stylesheet">
    <link href="css/font-awesome.css?v=4.4.0" rel="stylesheet">
    <!-- Morris -->
    <link href="css/plugins/morris/morris-0.4.3.min.css" rel="stylesheet">
    <!-- Gritter -->
    <link href="js/plugins/gritter/jquery.gritter.css" rel="stylesheet">
    <link href="css/animate.css" rel="stylesheet">
    <link href="css/style.css?v=4.1.0" rel="stylesheet">
    <link href="css/global.css" rel="stylesheet">
    <link href="css/sampleManage.css" rel="stylesheet">
</head>

<body class="gray-bg">
<div class="wrapper wrapper-content animated fadeInRight">
    <div class="manageTitle">
        <div class="manageTitleBack" onclick="javascript:history.back(-1);">
            <i class="fa fa-chevron-left"></i>
        </div>
        <span class="manageTitleText">样本信息录入</span>
    </div>
    <div class="ibox-content manageEditBox">
        <div class="floatClear manageEditInputBox">
            <div class="floatLeft manageEditLabel">ON号：</div>
            <input class="floatLeft manageEditInput" type="text" placeholder="请输入">
            <div class="floatLeft manageEditLabel">NB号：</div>
            <input class="floatLeft manageEditInput" type="text" placeholder="请输入">
        </div>
        <div class="floatClear manageEditInputBox">
            <div class="floatLeft manageEditLabel">姓名：</div>
            <input class="floatLeft manageEditInput" type="text" placeholder="请输入">
            <div class="floatLeft manageEditLabel">身份证号：</div>
            <input class="floatLeft manageEditInput" type="text" placeholder="请输入">
        </div>
        <div class="floatClear manageEditInputBox">
            <div class="floatLeft manageEditLabel">性别：</div>
            <select class="floatLeft manageEditSelect" id="">
                <option value="">请选择</option>
            </select>
            <div class="floatLeft manageEditLabel">是否为先证者：</div>
            <select class="floatLeft manageEditSelect" id="">
                <option value="">请选择</option>
            </select>
        </div>
        <div class="floatClear manageEditInputBox">
            <div class="floatLeft manageEditLabel">样本编号(选填)：</div>
            <input class="floatLeft manageEditInput" type="text" placeholder="请输入">
            <div class="floatLeft manageEditLabel">样本性质：</div>
            <select class="floatLeft manageEditSelect" id="">
                <option value="">请选择</option>
            </select>
        </div>
        <div class="floatClear manageEditInputBox">
            <div class="floatLeft manageEditLabel">样本类型：</div>
            <select class="floatLeft manageEditSelect" id="">
                <option value="">请选择</option>
            </select>
            <div class="floatLeft manageEditLabel">是否是重点客户：</div>
            <select class="floatLeft manageEditSelect" id="">
                <option value="">请选择</option>
            </select>
        </div>
        <div class="floatClear manageEditInputBox">
            <div class="floatLeft manageEditLabel">检测项目：</div>
            <select class="floatLeft manageEditSelect" id="">
                <option value="">请选择</option>
            </select>
            <div class="floatLeft manageEditLabel">样本数量：</div>
            <input class="floatLeft manageEditInput" type="text" placeholder="请输入">
        </div>
        <div class="floatClear manageEditInputBox">
            <div class="floatLeft manageEditLabel">样本总量：</div>
            <input class="floatLeft manageEditInput" type="text" placeholder="请输入">
            <div class="floatLeft manageEditLabel">剩余样本量：</div>
            <input class="floatLeft manageEditInput" type="text" placeholder="请输入">
            <span class="manageEditUl">ul</span>
        </div>
        <div class="floatClear manageEditInputBox">
            <div class="floatLeft manageEditLabel">项目负责人：</div>
            <select class="floatLeft manageEditSelect" id="">
                <option value="">请选择</option>
            </select>
            <div class="floatLeft manageEditLabel">中心接受人：</div>
            <select class="floatLeft manageEditSelect" id="">
                <option value="">请选择</option>
            </select>
        </div>
        <div class="floatClear manageEditInputBox">
            <div class="floatLeft manageEditLabel">实际收费(选填)：</div>
            <input class="floatLeft manageEditInput" type="text" placeholder="请输入">
            <div class="floatLeft manageEditLabel">收样日期：</div>
            <input class="floatLeft manageEditInput" placeholder="选择时间" onclick="laydate({istime: true, format: 'YYYY-MM-DD hh:mm:ss'})">
            <i class="fa fa-calendar manageEditCalendar"></i>
        </div>
        <div class="manageEditBtnBox">
            <div class="manageEditBtn manageEditBtnSave">
                <img src="img/save.png" alt="">
                保存
            </div>
            <div class="manageEditBtn manageEditBtnRemove" onclick="javascript:history.back(-1);">
                <img src="img/remove.png" alt="">
                取消
            </div>
        </div>
    </div>
</div>

<!-- 全局js -->
<script src="js/jquery.min.js?v=2.1.4"></script>
<script src="js/bootstrap.min.js?v=3.3.6"></script>
<script src="js/global.js?v=3.3.6"></script>
<!-- layerDate plugin javascript -->
<script src="js/plugins/layer/laydate/laydate.js"></script>
</body>
</html>
